Difference between revisions of "Sentinel lymph node biopsy"

Sentinel lymph node biopsy
Anesthesia type	GA, local with sedation
Airway	LMA
Lines and access	PIV sufficient
Monitors	standard
	Primary anesthetic considerations
Preoperative	Cancer considerations. Radioisotope tagging beforehand means that cancelling "elective" cases is discouraged once they have been tagged.
Intraoperative	avoid BP cuff on ipsilateral arm.
Postoperative	PONV (breast surgery). With local infilitration, pain is usually minimal.
	Article quality
Editor rating	In development
User likes	0

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Latest revision as of 06:32, 15 February 2024

Provide a brief summary here.

Overview

Indications

The sentinel lymph node is the first node or group of lymph nodes that drains from the primary cancer. Thus, it is used to check for metastastic breast cancer.

Surgical procedure

Carried out in conjunction with radioisotope tagging beforehand. The nodes with the highest degree of activity are removed.
Involves incision in axilla to excise corresponding nodes.

Preoperative management

Patient evaluation


System	Considerations
Airway
Neurologic
Cardiovascular
Pulmonary
Gastrointestinal
Hematologic
Renal
Endocrine
Other

Labs and studies

Operating room setup

Patient preparation and premedication

Regional and neuraxial techniques

Intraoperative management

Monitoring and access

Standard monitors
PIV sufficient

Induction and airway management

If GA - standard induction. Usually a fairly healthy population.
If MAC - propofol infusion +/- narcotic prn

Positioning

Supine. Arms out

Maintenance and surgical considerations

Emergence

Postoperative management

Disposition

Day procedure

Pain management

Usually small incision. Local infilitration +/- prn narcotic, multimodals sufficient.

Potential complications

Procedure variants


	Variant 1	Variant 2
Unique considerations
Indications
Position
Surgical time
EBL
Postoperative disposition
Pain management
Potential complications

References

Top contributors: Peter Tryphonopoulos

@@ Line 1: / Line 1: @@
+{{Infobox surgical procedure
+| anesthesia_type = GA, local with sedation
+| airway = LMA
+| lines_access = PIV sufficient
+| monitors = standard
+| considerations_preoperative = Cancer considerations.
+Radioisotope tagging beforehand means that cancelling "elective" cases is discouraged once they have been tagged.
+| considerations_intraoperative = avoid BP cuff on ipsilateral arm.
+| considerations_postoperative = PONV (breast surgery). With local infilitration, pain is usually minimal.
+}}
+Provide a brief summary here.
+== Overview ==
+=== Indications<!-- List and/or describe the indications for this surgical procedure. --> ===
+* The sentinel lymph node is the first node or group of lymph nodes that drains from the primary cancer. Thus, it is used to check for metastastic breast cancer.
+=== Surgical procedure<!-- Briefly describe the major steps of this surgical procedure. --> ===
+* Carried out in conjunction with radioisotope tagging beforehand. The nodes with the highest degree of activity are removed.
+* Involves incision in axilla to excise corresponding nodes.
+== Preoperative management ==
+=== Patient evaluation<!-- Describe the unique and important aspects of preoperative evaluation. Add or remove rows from the systems table as needed. --> ===
+{| class="wikitable"
+|+
+!System
+!Considerations
+|-
+|Airway
+|
+|-
+|Neurologic
+|
+|-
+|Cardiovascular
+|
+|-
+|Pulmonary
+|
+|-
+|Gastrointestinal
+|
+|-
+|Hematologic
+|
+|-
+|Renal
+|
+|-
+|Endocrine
+|
+|-
+|Other
+|
+|}
+=== Labs and studies<!-- Describe any important labs or studies. Include reasoning to justify the study and/or interpretation of results in the context of this procedure. If none, this section may be removed. --> ===
+=== Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none, this section may be removed. --> ===
+=== Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. --> ===
+=== Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> ===
+== Intraoperative management ==
+=== Monitoring and access<!-- List and/or describe monitors and access typically needed for this case. Please describe rationale for any special monitors or access. --> ===
+* Standard monitors
+* PIV sufficient
+=== Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> ===
+* If GA - standard induction. Usually a fairly healthy population.
+* If MAC - propofol infusion +/- narcotic prn
+=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> ===
+* Supine. Arms out
+=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===
+=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===
+== Postoperative management ==
+=== Disposition<!-- List and/or describe the postoperative disposition and any special considerations for transport of patients for this case. --> ===
+* Day procedure
+=== Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. --> ===
+* Usually small incision. Local infilitration +/- prn narcotic, multimodals sufficient.
+=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> ===
+== Procedure variants<!-- This section should only be used for cases with multiple approaches (e.g. Laparoscopic vs. open appendectomy). Otherwise, remove this section. Use this table to very briefly compare and contrast various aspects between approaches. Add or remove rows as needed to maximize relevance. Consider using symbols rather than words when possible (e.g. +, –, additional symbols such as ↑ and ↓ are available using the "Ω" tool in the editor). --> ==
+{| class="wikitable wikitable-horizontal-scroll"
+|+
+!
+!Variant 1
+!Variant 2
+|-
+|Unique considerations
+|
+|
+|-
+|Indications
+|
+|
+|-
+|Position
+|
+|
+|-
+|Surgical time
+|
+|
+|-
+|EBL
+|
+|
+|-
+|Postoperative disposition
+|
+|
+|-
+|Pain management
+|
+|
+|-
+|Potential complications
+|
+|
+|}
+== References ==
+[[Category:Surgical procedures]]